Concerns about a growing doctor shortage, especially in rural Kentucky, is fueling the urgency for lawmakers and medical groups to agree on an approach to allow nurse practitioners to be able to prescribe certain medicines without physician supervision.

Republican Senate President Robert Stivers broke the news Thursday at the Kentucky Hospital Association’s annual health leadership conference in Louisville that a compromise was in the works.

He said Sen. John Schickel, R-Union, has been working with officials from the Kentucky Medical Association, which represents doctors, and the nurse practitioners to come up with a proposal they can live with, which would almost assure its passage in 2014.

Stivers also explained why he supports the bill.

This year’s measure regarding nurse practitioners started in the Senate, then passed the House, 70-16, with changes urged by the nurse practitioners before stalling in the Senate.

Meanwhile, such compromise appears unlikely when it comes to medical malpractice reform.

Sen. Julie Denton, R-Louisville, sponsored a bill this year that would have created a review panel to screen lawsuits brought against nursing homes. It received strong opposition from many Democrats, particularly those who were lawyers like Sen. Ray Jones, D-Pikeville.

Denton, who chairs the Senate Health and Welfare Committee, told the more than 100 hospital executives at the Kentucky Hospital Association that their political action committees, as well as the Kentucky Medical Association’s PAC and the PAC for longterm care facilities should write checks to lawmakers who support tort reform and the election challengers of those who oppose it.

That did not sit well with her fellow panelist, Rep. Jimmie Lee, D-Elizabethtown and the chairman of the House budget panel that covers health programs.

A similar, yet more civil, divide played out between the leaders of the respective chambers: Stivers and Democratic House Speaker Greg Stumbo.

Correction: An earlier version of this article incorrectly listed the Kentucky Nurses Association PAC among the PACs Denton called out to contribute to legislative candidates.